Aging & Mental Health, Год журнала: 2024, Номер unknown, С. 1 - 8
Опубликована: Авг. 26, 2024
Objectives Various dementia risk scores exist that assess different factors. We investigated the association between Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) score modifiable factors in Lifestyle for Brain Health (LIBRA) a German population at high Alzheimer's disease.
Язык: Английский
The Lancet, Год журнала: 2024, Номер 404(10452), С. 572 - 628
Опубликована: Июль 31, 2024
Язык: Английский
Процитировано
731
Alzheimer s & Dementia, Год журнала: 2023, Номер 20(1), С. 615 - 628
Опубликована: Сен. 28, 2023
Abstract INTRODUCTION We investigated the effectiveness of a multidomain intervention to preserve cognitive function in older adults at risk for dementia Germany cluster‐randomized trial. METHODS Individuals with Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) score ≥ 9 aged 60 77 years were recruited. After randomization their general practitioner (GP), patients received (including optimization nutrition medication, physical, social, activity) or health advice GP treatment as usual over 24 months. Primary outcome was global performance (composite z score, based on domain‐specific neuropsychological tests). RESULTS Of 1030 participants baseline, n = 819 completed 24‐month follow‐up assessment. No differences regarding (average marginal effect 0.010, 95% confidence interval: –0.113, 0.133) found between groups follow‐up. Perceived restrictions conduct by COVID‐19 pandemic did not impact effectiveness. DISCUSSION The improve performance. Highlights Overall, no effects detected. improved health‐related quality life total sample. In women, reduced depressive symptoms. during pandemic.
Язык: Английский
Процитировано
32
International Journal of Stroke, Год журнала: 2024, Номер 19(8), С. 838 - 856
Опубликована: Сен. 16, 2024
Worldwide, around 50 million people live with dementia, and this number is projected to triple by 2050. It has been estimated that 20% of all dementia cases have a predominant cerebrovascular pathology, while perhaps another vascular diseases contribute mixed picture. Therefore, the contribution affects 20 currently will increase markedly in next few decades, particularly lower- middle-income countries. In review, we discuss mechanisms cognitive impairment (VCI) review management. VCI refers spectrum pathologies any degree impairment, ranging from subjective decline, mild dementia. While acute decline occurring soon after stroke most recognized form VCI, chronic disease, particular cerebral small-vessel can cause insidious absence stroke. Moreover, disease not only commonly co-occurs Alzheimer’s (AD) increases probability AD pathology result clinical but may also etiologically development pathologies. Despite its enormous health economic impact, neglected research area, adequately powered trials therapies, resulting proven treatments. Current management emphasizes prevention treatment risk factors, evidence for intensive hypertension control. Reperfusion therapies attenuate VCI. Associated behavioral symptoms such as apathy poststroke emotionalism are common. We highlight novel strategies hopefully lead new course-modifying therapies. Finally, importance including endpoints large cardiovascular need an increased focus funding important area.
Язык: Английский
Процитировано
13
Ageing Research Reviews, Год журнала: 2024, Номер 100, С. 102463 - 102463
Опубликована: Авг. 23, 2024
Язык: Английский
Процитировано
9
Alzheimer s Research & Therapy, Год журнала: 2024, Номер 16(1)
Опубликована: Июнь 13, 2024
Abstract Background Evidence on the effectiveness of multidomain lifestyle interventions to prevent cognitive decline in older people without dementia is mixed. Embedded World-Wide FINGERS initiative, FINGER-NL aims investigate a 2-year intervention functioning Dutch at risk individuals. Methods Multi-center, randomized, controlled, trial with duration 24 months. 1210 adults between 60–79 years old presence ≥ 2 modifiable factors and 1 non-modifiable factor for were recruited January 2022 May 2023 via Brain Research Registry across five study sites Netherlands. Participants randomized either high-intensity or low-intensity group. The comprises combination 7 components (physical activity, training, cardiovascular management, nutritional counseling, sleep stress social activities) product (Souvenaid®) that could help maintain functioning. group receives personalized, supervised hybrid consisting meetings (on-site online) individual sessions guided by trained coach, access digital platform provides custom-made training materials selected apps. bi-monthly online lifestyle-related health advice platform. Primary outcome change composite score covering processing speed, executive function, memory. Results Within 17 months, participant recruitment has been successfully completed ( N = 1210; mean age: 67.7 (SD: 4.6); 64% female). Modifiable commonly present baseline physical inactivity (89%), low mental/cognitive activity (50%), engagement (39%), hypertension (39%) high alcohol consumption (39%). body mass index participants was 28.3 4.2) total serum cholesterol 5.4 mmol/L 1.2). Conclusions Baseline clinical measurements showed successful sufficient potential prevention. will provide further insight into efficacy adults. Trial registration ClinicalTrials.gov (ID: NCT05256199)/2022–01-11.
Язык: Английский
Процитировано
7
Alzheimer s & Dementia, Год журнала: 2024, Номер 20(8), С. 5684 - 5694
Опубликована: Июль 5, 2024
Abstract INTRODUCTION Dementia risk scores constitute promising surrogate outcomes for lifestyle interventions targeting cognitive function. We investigated whether dementia risk, assessed using the LIfestyle BRAin health (LIBRA) index, was reduced by AgeWell.de intervention. METHODS Secondary analyses of AgeWell trial, testing a multicomponent intervention (including optimization nutrition, medication, and physical, social, activity) in older adults with increased risk. analyzed data from n = 461 participants complete information on risk/protective factors comprised LIBRA at 24‐month follow‐up. Intervention effects components were generalized linear models. RESULTS The scores, indicating decreased follow‐up ( b –0.63, 95% confidence interval [CI]: –1.14, –0.12). particularly due to improvements diet (odds ratio [OR]: 1.60, CI: 1.16, 2.22) hypertension (OR: 1.61, 1.19, 2.18). DISCUSSION However, several did not improve, possibly requiring more intensive interventions. Highlights according scores. Beneficial are mainly changes blood pressure. A pragmatic is apt reduce an at‐risk population.
Язык: Английский
Процитировано
7
Alzheimer s Research & Therapy, Год журнала: 2024, Номер 16(1)
Опубликована: Июнь 22, 2024
Abstract Background Aim of this study was to detect predictors better adherence the AgeWell.de-intervention, a two-year randomized multi-domain lifestyle intervention against cognitive decline. Methods Data 317 group-participants comprising risk group for dementia (Cardiovascular Risk Factors, Ageing and Dementia (CAIDE) score ≥ 9; mean age 68.9 years, 49.5% women) from AgeWell.de were analysed. Regression models with four blocks (sociodemographic, psychosocial, factors chronic conditions) run on components nutrition, enhancement social physical activity training. Adherence each component operationalised by assessing degree goal achievement per at up seven time points during period, measured using 5-point Likert scale (mean achievement). Results Increasing negatively associated adherence, while higher education positively predicted adherence. Participants mental state (Montreal Cognitive Assessment (MoCA)-score > 25) baseline self-efficacy adhered better. Diabetes cardiovascular conditions not whereas smoking affected Highest quitting in past only all components. Conclusion identified worse Particularly seems be considerable influence This should considered when designing future trials. Trial registration German Clinical Trials Register (ref. number: DRKS00013555).
Язык: Английский
Процитировано
6
The Journal of Prevention of Alzheimer s Disease, Год журнала: 2024, Номер unknown
Опубликована: Янв. 1, 2024
Язык: Английский
Процитировано
5
Опубликована: Фев. 8, 2024
Engagement in cognitive and social activities can potentially preserve abilities, which makes their promotion a promising avenue for dementia risk reduction. However, insight into how to adequately measure engagement these is necessary precursor. A rapid scoping review was performed search relevant articles on PubMed. The aim obtain an initial understanding of (a) are measured research that investigates protective against (b) explore what extent this aligns with the operationalization preventive interventions. findings show across 58 studies, questionnaires were mostly used activities. wide variety items themes observed including: arts crafts; clubs, groups, communities; exercising; games puzzles; going out; household tasks; learning education; making music; multimedia usage; reading; socializing; work/volunteering; writing. There considerable variations number content items, ulitized response scales, recall periods, methods compose scores. Additionally, interventions stongly focused psychoeducation (computerized) training, limitedly reflect operationalized questionnaires.Many researchers investigate effects or but promote concepts completely differently. This results fragmented insights protective. Clarifying precisely entail, aspects would support development measurement instructions as well activities.Keywords: Dementia, Cognition, Social Participation, Cognitive Activities, Activities
Язык: Английский
Процитировано
3
Alzheimer s & Dementia Translational Research & Clinical Interventions, Год журнала: 2025, Номер 11(1)
Опубликована: Янв. 1, 2025
Abstract INTRODUCTION The societal costs of dementia and cognitive decline are substantial likely to increase during the next decades due increasing number people in older age groups. aim this multicenter cluster‐randomized controlled trial was assess cost‐effectiveness a multi‐domain intervention prevent who at risk for dementia. METHODS We used data from multi‐centric, two‐armed, ( AgeWell.de trial, ID: DRKS00013555). Eligible participants with increased baseline (Cardiovascular Risk Factors, Aging, Incidence Dementia/CAIDE Dementia Score ≥ 9), 60–77 years age, were recruited by their general practitioners, assigned randomly lifestyle or health advice. performed analysis perspective. time horizon 2 years. Health care utilization measured using “Questionnaire Health‐Related Resource Use Older Populations.” As effect measure, we quality‐adjusted life‐years (QALYs) based on 5‐level EQ‐5D version (EQ‐5D‐5L). calculated incremental ratios (ICER) acceptability curves (CEAC) net‐benefit approach. Exploratory analyses considering women EQ visual analogue scale (EQ VAS) conducted. RESULTS Data available 819 (mean 69.0 [standard deviation (SD)5‐level 4.9]); 378 treated group 441 control group. caused higher (+€445.88 [SD: €1,244.52]) gained additional effects (+0.026 QALY 0.020]) compared (the difference statistically significant). ICER €17,149.23/QALY. CEAC showed that probability being cost‐effective moderate, reaching 59% willingness‐to‐pay (WTP) €50,000/QALY. exploratory promising results, especially female subsample. DISCUSSION Considering aspects like WTP limited horizon, Highlights first German randomized (RCT) evaluating multicomponent approach against decline. found favorable ratio. reached 78.6%. Women could be an important target A longer is needed.
Язык: Английский
Процитировано
0